9-Equal Opportunity Form.pdf
PDF 293 KB Posted
- Solicitation number
- 237352
- Issued by
- Pulaski County, Arkansas
About this file
This is an Equal Opportunity Certification Form required for subcontractors pursuant to Executive Order 11246 in connection with the Little Rock Kanis Park Loop (TAP-22) project (Job 061776) in Arkansas. The form serves as an initial certification requirement for any bidder or prospective contractor and their proposed subcontractors to disclose their participation history in previous contracts subject to equal opportunity clauses. The certification requires subcontractors to state whether they have participated in prior contracts or subcontracts subject to the Equal Opportunity Clause and whether all required compliance reports have been filed. The form must be completed and signed by an authorized representative of the subcontractor, including the subcontractor's name, address with ZIP code, and the date of certification.
The certification process includes four key questions requiring yes or no responses: whether the bidder has participated in a previous contract or subcontract subject to the Equal Opportunity Clause; whether compliance reports were required to be filed; whether all required compliance reports have been filed; and whether the bidder has been or is being considered for sanctions due to violations of Executive Order 11246. Where certification indicates that a subcontractor has failed to file required compliance reports, the subcontractor must submit a compliance report before the project owner approves the subcontract or permits work to commence. The form requires the signature of a certifying official with typed name and title, along with the date of signature.
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Text version
Signature of Certifying Official Date
CERTIFICATION BY PROPOSED SUBCONTRACTOR REGARDING
EQUAL EMPLOYMENT OPPORTUNITY
NAME OF PRIME CONTRACTOR PROJECT NUMBER
INSTRUCTIONS:
The certification is required pursuant to Executive Order 11246 (30 F.R. 12319-25). The implementing rules and regulations provide that any bidder or prospective contractor, or any of their proposed subcontractors, shall state as an initial part of the bid or negotiations of the contract whether it has participated in any previous contract or subcontract subject to the equal opportunity clause; and, if so, whether it has filed all compliance reports due under applicable instructions.
Where the certification indicates that the subcontractor has not filed a compliance report due under applicable instructions, such subcontractor shall be required to submit a compliance report before the owner approves the subcontract or permits work to begin under the subcontract.
SUBCONTRACTOR'S CERTIFICATION
NAME AND ADDRESS OF SUBCONTRACTOR (Include ZIP Code):
1. Bidder has participated in a previous contract or subcontract subject to the Equal Opportunity Clause.
YES NO
2. Compliance reports were required to be filed in connection with such contract or subcontract.
YES NO
3. Bidder has filed all compliance reports due under applicable instructions.
4. Have you ever been or are you being considered for sanction due to violation of Executive Order 11246, as amended?
NAME AND TITLE OF SIGNER (Please type):
SIGNATURE: DATE:
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